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Med-Surg I > Exam 1 > Flashcards

Exam 1 Flashcards

1
Q

ACE (in terms of pain)

A

Assess: for pain and rating
Care: manage patient
Educate: addiction, don’t wait until pain is severe

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2
Q

When do you see side effects of a med

A

Peak

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3
Q

IASP definition of pain

A

An unpleasant sensory and emotional experience associated with actual or potential tissue damage, or described in terms of such damage

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4
Q

McCaffery’s definition of pain

A

Whatever the pt says it is, whenever the pt says it is

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5
Q

JHACO standards (2)

A

All pts must be assessed for pain
All pts have the right to appropriate assessment and management of pain

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6
Q

Peak respiratory depression (IV, IM, SQ, epidural, transdermal)

A

IV: 15 min
IM: 30
SQ: 90
epidural: 6-12 hrs
transdermal: 12-18 hrs

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7
Q

Joint commission accredits pain specific components such as (4)

A

location
onset
alleviating factors
aggravating factors

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8
Q

Adaptation response

A

pt has pain but doesn’t show parasympathetic symptoms; withdrawal from social interactions & depression seen

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9
Q

Nociceptive pain and 4 steps

A

Normal
transduction (pain converted to electrical impulse in horns)
transmission (neurotransmitters regulate pain perception and go to cortex)
perception (we understand the pain)
modulation (modulate the pain)

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10
Q

endorphins

A

body’s natural morphine system, delays transmission of pain (also from placebo)

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11
Q

neuropathic pain

A

nerve injury usually peripheral
ex. diabetic neuropathy or phantom pain

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12
Q

Pain STIMULATING chemicals (5) and what do they do

A

histamine
bradykinin
acetylcholine
potassium
prostaglandins

they stimulate the inflammatory process

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13
Q

Pain CONTROLLING chemicals (3) and what they do

A

enkephalins
endorphins
serotonin

They modulate the pain

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14
Q

Biologic pain

A

Internal

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15
Q

Chemical pain

A

Caused by internal chemical, such as ulcers

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16
Q

Physical pain

A

caused by outside stimuli, like a tight cast

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17
Q

chronic intermittent pain

A

comes and goes like migraines

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18
Q

cancer related pain

A

from disease progression and treatment options

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19
Q

superficial pain

A

cutaneous, like a cut

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20
Q

Deep somatic pain

A

bone, muscle, blood vessels, connective tissue

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21
Q

visceral pain

A

pain from internal organs

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22
Q

localized pain

A

confined to site of origin

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23
Q

referred pain

A

pain that is felt somewhere else (like arm pain from an MI)

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24
Q

Intractable pain

A

high resistance to pain relief (nothing works)

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25
Q

Breakthrough pain

A

pain that occurs between doses of pain meds

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26
Q

acute pain

A

Mild-severe
sympathetic NS responses (observable)
related to a specific injury
resolves with healing
restless and anxious
reports of pain
pain behavior

definite start, occurs as a result of an injury, definite end time

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27
Q

Chronic pain

A

mild-severe
adaptation response
parasympathetic NS responses

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28
Q

cancer related pain

A

progression of cancer
treatment
acute or chronic
need large dose of pain med

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29
Q

Adaptation response

A

vital signs
facial expression
shifting away or guarding
reporting pain only if asked
sleepiness
limited physical activity
withdrawing

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30
Q

pain in the elderly

A

typically passive, may deny pain (ego or “normal” feeling)
more sensitive to drugs
chronic pain undertreated
sleep deprivation and fatigue=longer healing time

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31
Q

addiction

A

compulsion characterized by behaviors that include impaired control over drug use, compulsive use, continued use, despite harm and craving mostly for psychic effects

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32
Q

dependence

A

opioids taken over a long period of time with abrupt cessation, rapid dose reduction, decreasing blood level of the drug, and/or administration of an antagonist
not an addiction
state of adaptation

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33
Q

physical dependence

A

drug class specific withdrawal syndrome
physical withdrawal, suddenly stopped

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34
Q

Psychological dependence

A

emotional craving for drug effect
prevent occurrence with withdrawal symptoms

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35
Q

tolerance

A

decreased sensitivity to analgesic
properties of opioid with need for increasing doses to maintain level of pain relief
adequate pain relief no longer obtained
state of adaptation

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36
Q

pain assessment

A

triggers/relief
associated s/s
intensity (scale)
threshold (when they feel pain)
tolerance (max amount of pain someone is willing to take)
location
quality
onset and duration
personal meaning
allergies

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37
Q

OPQRST

A

objective signs
provoked by what
quality
region
severity
timing

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38
Q

objective pain signs (5)

A

sympathetic, parasympathetic, verbal, nonverbal, adaptation response

unreliable on their own

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39
Q

what do we want to do when managing pain (6)

A

reduce anxiety
prevention (periodic meds)
PCA
placebos
anesthetic blocks
non-pharmacological

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40
Q

what do placebos set off

A

the internal morphine system

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41
Q

adjuvant analgesics (4)

A

Given with or in place of other pain relief meds:
steroids
antihistamines
anticonvulsants
antianxiety

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42
Q

non-opioid analgesics

A

salicylates (aspirin)
acetaminophen (tylenol)
NSAIDS

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43
Q

aspirin side effects (2)

A

tinnitus
decreased effectiveness of NSAIDS

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44
Q

NSAIDs side effects (2)

A

increased sodium retention
GI bleeding and irritation
take with food or milk

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45
Q

adverse effects of opioids

A

resp depression

tolerance of side effects:
itching (solved with benadryl)
constipation (ambulate)

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46
Q

what does massaging do

A

releases internal morphine (endorphins)

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47
Q

contralateral stimulation

A

massage opposite of where injury is

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48
Q

diathermy

A

pulsations (like a sonogram), produces heat

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49
Q

what is TENS used for

A

intractable or chronic pain

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50
Q

nursing problems: pain

A

fatigue, impaired mobility, self care deficit, ineffective airway clearance, impaired gas exchange, hopelessness, ineffective coping, ineffective health maintenance, disturbed sleep pattern, deficit knowledge

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51
Q

Functions of body fluids (4)

A

transport nutrients to cells and waste away
maintain homeostasis
tissue lubricant
temperature regulation

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52
Q

ICF amount

A

2/3 of our body water
40% of our weight

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53
Q

ECF amount

A

1/3 of our body water
20% of our weight

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54
Q

intracellular spacing

A

1st spacing
when fluids are where they’re supposed to be

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55
Q

extracellular spacing

A

2nd spacing
fluid leak-edema

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56
Q

transcellular spacing

A

3rd space
synovial, CFS, pericardial, pleural [effusion- ascites], intraocular (areas with little to no water usually)
fluid is trapped
must be removed with a needle
leads to hypervolemia/weight gain

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57
Q

dehydration vs hypovolemia

A

dehydration: only ECF, electrolytes become more concentrated
hypovolemia: ICF and ECF fluid volume deficit, loss of electrolyte (ex. hemorrhage)

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58
Q

hypovolemia manifestations (8)

A

oliguria, tachycardia/pnea, generalized edema (non pitting), weight gain, fever, constipation, abdominal cramps

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59
Q

solvent

A

the liquid doing the dissolving

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60
Q

solute

A

the stuff getting dissolved

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61
Q

hydrostatic pressure

A

pushes fluid out of capillaries (interstitial space) and into interstitial fluid

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62
Q

plasma colloid osmotic pressure

A

holds fluid inside the capillary
pulling force of albumin
albumin holds fluid in capillaries, important w edemas
kidney failure=disruption

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63
Q

what happens when kidneys can’t filter out protein

A

kidney increase in colloidal osmotic pressure

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64
Q

how do age and body fat content affect fluid and electrolye balance

A

Age: body fluids increase in younger than older
Body fat content: thin and women> obese and men bc fat cells/adipose tissue have little water

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65
Q

GI factors effecting fluid/electrolyte balance

A

nasogastric suctioning, vomit, diarrhea

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66
Q

environmental factors effecting fluid/electrolyte balance

A

vigorous exercise, high altitudes, dry climates, alcohol, caffeine, diuretics, heart and blood vessels, respiration (insensible water loss)

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67
Q

hypovolemic shock

A

bad
temp regulation (up to 105F)
impaired thought process
sodium loss (abdominal cramps)

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68
Q

Behavior, skin, tongue, vitals, etc in fluid volume deficit

A

behavior: confusion, combativeness, coma
flattened veins, oliguria, dark, high specific gravity
skin: poor turgor, loss of IS space fluid
tongue: dry and furrowed
vital signs (low BP, high HR, high temp), SOB, paresthesia, muscle cramps
neuromuscular irritability
fatigue

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69
Q

nursing management of FVD

A

identify and assess, look to replace I&O, daily weight, abdominal girth measuring

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70
Q

FVD related factors

A

decreased fluid intake (imposed fluid restriction, inability to swallow or obtain fluids)
depression
increased needs for fluids (strenuous exercise, extreme heat or dryness, fever)
abnormal fluid loss (V/D, abdominal surgery, abnormal drainage, skin trauma, laxatives, enemas, blood loss, diaphoresis, polyuria)

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71
Q

FVD defining characteristics

A

extreme thirst
irritability
dizziness
weakness
fever
dry skin
dry mucous membranes
sunken eyes
poor skin turgor
decreased urine output

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72
Q

FVD interventions

A

encourage gradual fluids
lactated ringers
good skin care (moisturizing)

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73
Q

sodium/water retention

A

renal failure/nephrotic syndrome
decreased CO
liver disease/cirrhosis
hormonal problems (cushing’s=too much cortisol)
weight gain
swollen (enema), JVD, pulmonary edema, pleural effusion, altered LOC, seizures (cerebral edema)

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74
Q

excessive sodium or fluid intake causes (5)

A

IV infusion with Na, blood or plasma replacement
albumin infusion
administration of hypertonic solutions
GI irrigation with hypotonic solution
corticosteroid therapy

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75
Q

fluid volume excess (hypervolemia)

A

hemodilution
polyuria, decreased BUN, hematocrit, and specific gravity
strict I&O
monitor resp status and pulmonary complications, ABG, O2 therapy, sodium/fluid restrictions (meds w meals)

pt teaching: seasonings, NOT salt, hold water in mouth to moisten, 45 angle bed

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76
Q

what 2 kinds of meds cause hyponatremia

A

anticonvulsants and sedatives

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77
Q

hypernatremia causes (MODEL)

A

Medications (antacids), meals
osmotic diuretics
diabetes insipidus
excessive water loss
low water intake

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78
Q

euvolemic hypernatremia

A

sodium content increases while total body water remains near normal. usually caused by excess sodium intake

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79
Q

hyponatremia nursing interventions

A

monitor for confusion
remove underlying problem

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80
Q

hypernatremia defining characteristics (FRIED SALT)

A

Flushed skin
restless
increased BP and fluid retention
edema peripheral and pitting
decreased urine output and dry mouth

skin flushed
agitation
low grade fever
thirst

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81
Q

potassium normal values

A

3.5-5

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82
Q

hypokalemia

A

98% of body’s K+ is in the cell (excitability, conduction, contraction)
80% K+ exerted from kidneys
body can’t hold onto potassium

83
Q

disturbances causing hypokalemia

A

suctioning, severe diaphoresis, chronic kidney failure, diuretic drugs (furosemide), excess insulin administration, asthma drugs, excessive sweating, vomiting

84
Q

hypokalemia defining characteristics (DA SIC WALT!!)

A

decreased intestinal motility (N/V, ileus)
alkalosis (increased K+ secretion)

shallow respirations (causes alkalosis)
irritability
confusion, drowsiness

weakness, fatigue
arrythmias: tachycardia and irregular rhythm
lethargy
thready pulse

85
Q

hyperkalemia related factors

A

intracellular shift (K+ release due to cell lysis)
impaired renal excretion
addison’s disease
renal insufficiency
drugs (diuretics)

rare if kidneys are functioning properly

86
Q

hyperkalemia defining characteristics

A

muscle twitches, cramps, paresthesia
irritability and anxiety
low BP
dysrhythmias (bradycardia)
abdominal cramping
diarrhea

87
Q

hyperkalemia interventions

A

no potassium-saving diuretics (loop instead)
kayexalate: contrasts hyperkalemia
effects: sits in intestines for 4-6 hrs
insulin
calcium glutamate
pt teaching: no salt subs and eat fruits and berries

88
Q

normal Ca values

A

8.5-10.5

89
Q

hypocalcemia causes (10)

A

hyperthyroidism
renal failure
pancreatitis
parathyroid impairment
excessive laxative use
lack of movement= decreased absorption
alcohol & nicotine
breastfeeding
anorexia/bulimia
burns or infection

90
Q

hypocalcemia defining characteristics

A

nerve fiber irritability
anxiety
irritability
paresthesia around the mouth
diarrhea
skin conditions
muscle cramps/twitching/spasm
hyperactive DTRs
seizures
trousseau’s and chvostek’s signs

91
Q

trosseau’s sign

A

hands and fingers spasm when blood flow is decreased
apply BP cuff to the pt’s upper arm, inflate to 20mmHg above SPB

if in 1-4 minutes, pt experiences: adducted thumb, flexed wrist and metacarpophalangeal joints, extended interphalangeal joints, carpopedal spasm

92
Q

chvostek’s sign

A

tap pt’s face next to the ear
brief contraction of face

93
Q

hypercalcemia related factors

A

hyperparathyroidism (increased Ca absorption)
breast cancer
renal failure
meds (vit d overuse, antacids, diuretics)
decrease in smooth muscle
dehydration

94
Q

hypercalcemia s&S

A

nonspecific
confusion
muscle weakness
bone pain
kidney stones
arrythmias, cardiac arrest
excessive urination

95
Q

hypercalcemia interventions

A

increase mobilization and hydration
avoid dairy
may need hemodialysis

96
Q

Mg normal values

A

1.5-2.6

97
Q

hypomagnesemia causes

A

poor dietary intake
intestinal malabsorption
excessive Mg excretion
drugs (laxatives, antibiotics, loop diuretics, thiazide diuretics)
hypercalcemia
hyperphosphatemia
metabolic acidosis

98
Q

hypomagnesemia interventions

A

increase Mg supplements
educate about mg foods (broccoli, kale)
educate abt diuretic use

99
Q

hypermagnesemia causes

A

renal failure
ingesting too much
tumor lysis syndrome
excessive drugs, antacids, mg sulfate
preeclampsia
DKA (makes you hold onto Mg)

100
Q

hypermagnesemia defining characteristics

A

everything slows down!
bradycardia, hypotension
flushed skin
decreased muscle and nerve activity
hypoactive DTRs
generalized weakness
N/V
decreased bowel sounds, LOC
slow, shallow, depressed respirations
respiratory arrest

101
Q

hypermagnesemia interventions

A

administer fluids
reorient pt
monitor respirations
monitor bowel movements

102
Q

phosphate normal levels

A

2.5-4.5 in adults
6-7 in kids

103
Q

hypophosphatemia S&S (cardiac, renal, blood, brain, lungs, GI muscles)

A

cardiac: hypotension, tachy, failure and arrest
renal: AKI
blood: anemia, hemolysis, thrombocythemia
brain: confusion, coma, encephalopathy, seizures
lungs: resp failure, pulmonary edema
GI: anorexia, diarrhea, ileus
muscles: weakness, paresthesia, neuropathy, rhabdomyolysis, tetany

104
Q

hypophosphatemia nursing interventions

A

mild: high phosphorus diet (eggs, nuts, whole grains, meat, fish, poultry, milk)
moderate: oral supplements
severe: IV potassium phosphate or sodium phosphate and seizure precautions

105
Q

arterial pH

A

% of hydrogen ions in a solution
(% lost or gained)

106
Q

volatile acids

A

excreted from the body as a gas

107
Q

nonvolatile/fixed acids

A

excreted by the kidneys

108
Q

blood chemical buffers

A

1st line of defense
instantly regulates hydrogen

hydrogen is held or released in the plasma (immediate)

109
Q

resp system in acid/base balance

A

controls CO2 within minutes
2nd line of defense

110
Q

kidneys in acid/base balance

A

excrete or retain bicarb as needed
3rd line of defense
hours-days

111
Q

resp failure (acid/base)

A

kidneys excrete water, regenerating carbonic acid, lose hydrogen, and retain bicarb

PaCO2

112
Q

kidney disease

A

impairs excretion of fixed acids, resp system increases ventilation to get rid of excess acid as carbon dioxide

metabolic acidosis

113
Q

ABG normal values

A

pH: 7.35-45
PaCO2: 35-45
HCO3: 21-28

114
Q

resp acidosis risk factors

A

hypoventilation (COPD)
resp depression (any condition where pt retains CO2)
barbiturate or sedative overdose
Guillain-barre syndrome or some other neuromuscular weakening disease
ribcage injuries
resp arrest

115
Q

how long does resp acidosis take to resolve and pH in acute and chronic

A

acute: within 3 days, low pH
chronic: longer than 3 days, pH normal

116
Q

acidosis symptoms

A

headache, sleepy, confused, LOC, coma, too much CO2, less O2
seizures, weakness
diarrhea
SOB, coughing
increased HR
hypercapnia
N/V

117
Q

acidosis treatment

A

monitor for all symptoms
correct underlying condition
assist with ventilation
maintain patent airway

118
Q

aspirin in terms of alkalosis

A

can stimulate respirations

119
Q

metabolic acidosis risk factors

A

cardiac arrest
aspirin overdose
excess production of acids
DKA
lactic acidosis
starvation with lactic acidosis
inadequate loss of acids (urema, renal tubular acidosis)
excess loss of base (severe diarrhea)

120
Q

metabolic acidosis nursing interventions

A

treat underlying causes (diarrhea, DKA)
monitor K+ levels
monitor neurological status
provide mechanical ventilation
dialysis as ordered

121
Q

metabolic alkalosis risk factors

A

loss of acids (vomiting, excess GI suctioning, diuretic therapy)
base or buffer imbalance (K+ deficit, excess NaHCO3 intake [Alka-Seltzer])
disease states (cushing’s kidney)
multiple transfusion
overcorrection of acidosis

122
Q

nursing responsibilities for oncology

A

understand how lives are affected
understand the patho
identify pts at risk
prevention
nursing care
identify support services
support pts and family

123
Q

incidence of cancer (age, gender, race)

A

higher in older ppl and men
high mortality rate among African Amercians

124
Q

most common cancers

A

colon and lung

125
Q

what does it mean to be cured of cancer

A

cancer free for 5 years

126
Q

leading cause of stomach cancer

A

H. Pylori

127
Q

benign cell growth

A

does not usually require intervention
tight adherence
no migration
orderly growth
normal chromosomes
continuous appropriate cell growth
specific morphology
small nuclear-to-cytoplasmic ratio
specific, differentiated

128
Q

malignant cell growth

A

indicates cancer
loose adherence
migration
no contact inhibition
rapid or continuous
abnormal chromosomes

129
Q

patho of carcinogenesis

A

normal cells turning into cancer cells

130
Q

stages of carcinogenesis

A

initiation
promotion
malignant conversion/progression
metastasis

131
Q

steps of metastasis

A

malignant transformation
tumor vascularization
blood vessel penetration
arrest and invasion

132
Q

malignant transformation

A

some normal cuboidal cells have undergone malignant transformation and have divided enough times to form a tumorous area within the cuboidal epithelium

133
Q

tumor vascularization

A

cancer cells secrete tumor angiogenesis factor (TAF) stimulating the blood vessels to bud and form new channels that grow into the tumor

134
Q

blood vessel penetration

A

Cancer cells have broken off from the main tumor. Enzymes on the surface of the tumor cells make holes in the blood vessels, allowing cancer cells to enter blood vessels and travel around the body.

135
Q

arrest and invasion

A

Cancer cells clump up in blood vessel walls and invade new tissue areas. If the new tissue areas have the right conditions to support continued growth of cancer cells, new tumors (metastatic tumors) will form at this site.

136
Q

4 ways cancer cells spread

A

routes (liver, lymph nodes, lung, bone, brain)
seeding
lymphatic
blood-borne metastasis

137
Q

seeding

A

projection and invading of surrounding tissue

138
Q

lymphatic spread

A

pass between lymphatic circulation

139
Q

blood borne metastasis

A

vascular system to distant sites, organs, and internal cavities

140
Q

cancer risk factors

A

viruses and bacteria
physical agents (the sun, cigarettes)
chemical agents (tobacco, asbestos)
genetics
hormones (estrogen)
diet (processed foods like ham, bacon, burgers, hot dogs, red meat, organ meat, dyes)

141
Q

CAUTION in cancer

A

change in bowel or bladder
a lesion that doesn’t heal
unusual bleeding or discharge
thickening or lump in breast or elsewhere
indigestion or difficulty swallowing
obvious changes in wart or mole
nagging cough or persistent hoarseness

142
Q

cancer care and control (prevention levels)

A

primary: healthy people
secondary: screening for those at risk
tertiary: after diagnosis

approaches: education, regulation, host modification

143
Q

grading of tumors

A

degree of malignancy
type of tissue
differentiation
numeric value

144
Q

staging of tumors

A

stage 0-4
TNM system

T-extent of primary tumor
N-node involvement
M-extent of metastasis

145
Q

T in TNM

A

1: 1-3 cm
2: 3-5 cm
3: 5-7 cm
4: 7+ cm

146
Q

N in TNM

A

0: no nodes involved
1: mobile nodes
2: fixed nodes

147
Q

M in TNM

A

0: no metastasis
1: demonstrable metastasis
2: suspected metastasis

148
Q

stage 0 cancer

A

carcinoma in situ

149
Q

stage 1-3 cancer

A

disease is more extensive, such as larger tumor size or spread

150
Q

stage 4 cancer

A

spread to distant tissues and organs

151
Q

cancer treatment (5)

A

surgery
radiation
chemo
biotherapy
bone marrow transplant

152
Q

cancer treatment goals

A

cure, control, palliation, rehab

153
Q

4 types of cancer surgery

A

diagnostic (excision)
prophylactic
palliative
reconstructive

154
Q

3 types of biopsies

A

excisional (removes whole tumor)
incisional (removed part of tumor)
needle (removes tissue to diagnose)

155
Q

wide vs radical excision surgery

A

wide: removes involved area
radical: removes whole thing

156
Q

radiation therapy

A

primary, adjuvant, palliative
external beam (teletherapy)
internal radiation (brachytherapy, sealed-source, unsealed source)

157
Q

radiation safety standards

A

distance (6 ft), time (30 min/8 hrs), shielding (in x-ray area)
avoid handling if dislodged

158
Q

sealed internal radiation

A

stays in place by itself and becomes inactive. May need an applicator to keep in place. low level radiation

159
Q

unsealed internal radiation

A

administered IV or IO so it’s distributed

160
Q

brachytherapy

A

use of radioactive materials in contact with or implanted into the tissues to be treated

161
Q

dysgeusia and xerostomia

A

dysgeusia (altered state of sensation)
xerostomia (dry mouth)

162
Q

myelosuppression: thrombocytopenia

A

assess for bleeding
apply pressure to sites of needle sticks
avoid invasive procedures if possible

163
Q

myelosuppression: leukopenia

A

abnormally low WBC count

brush and floss after every meal not if bleeding
no petro jelly
no exposure to dirt
no flowers
rinse toothbrush w bleach, no mouthwash
bathe daily w antimicrobial soap
nothing fresh

164
Q

chemo goals

A

cure, control (increase survival time), palliate (decrease chance of life-threatening complication), antineoplastics

165
Q

antineoplastic

A

pertaining to the prevention of growth and spread of cancer cells

166
Q

types of chemo

A

primary
adjuvant
neoadjuvant (before surgery)

167
Q

chemo guidelines

A

oncology certified nurse
verification
PPE
body fluids and excreta (contaminated 48h after chemo)

168
Q

routes of chemo administration

A

regional
oral
IV

169
Q

regional chemo (intra-arterial, intracavitary, intraperitoneal, intrathecal)

A

topical
intra-arterial (straight to organs)
intracavitary (bladder)
intraperitoneal
intrathecal (CNS)

170
Q

IV chemo

A

VAD
PICC
extravasation
hypersensitivity reaction

171
Q

extravasation

A

escape of blood from vessel into the tissue

destroys the tissue, skin is gone
life threatening (line of defense is gone)
can become easily infected

172
Q

biotherapy

A

alters immunologic relationship between pt and tumor

173
Q

restoration, modification, stimulation, augmentation of body’s immune system

A

growth factor inhibitors
biologic response modifiers
monoclonal antibodies

174
Q

complementary treatment approaches

A

alternative/integrative therapy

175
Q

bone marrow transplant (allogenic, autologous, and syngeneic)

A

allogenic: donor other than the pt (GVHD)
autologous: pt
syngeneic: identical twin

176
Q

treatment modalities

A

nonspecific agents
interferons (IFN)
interleukins
monoclonal antibodies

177
Q

interferons (IFN)

A

when used, shorten periods of neutropenia
inhibit/stimulate immune system
fatigue, muscle aches
flu-like symptoms

178
Q

interleukins

A

strengthens immune response
hypotension, ascites, pulmonary edema, fatigue, weight gain, rash

179
Q

monoclonal antibodies

A

destroy cancer cells
spares normal cells

180
Q

anticancer drugs
adverse reactions

A

bone marrow suppression
N/V
anorexia
GI disturbance
alopecia
avoid preg

181
Q

integumentary effects of cancer

A

skin reactions
mucositis
stomatitis
alopecia

182
Q

reproductive system effects of cancer

A

sterility
loss of libido
impotence

183
Q

oncologic emergencies

A

infection, septic shock
hemorrhage
hypercalcemia
tumor lysis syndrome
SIADH
disseminated intravascular coagulation
spinal cord suppression
superior vena cava syndrome

184
Q

6 things to check for w cancer

A

imbalanced nutrition
risk for infection
impaired skin integrity
impaired tissue integrity
chronic pain
fatigue

185
Q

psychosocial aspects of cancer

A

hospice
support for pt and family
promoting positive self concept
promoting coping

186
Q

Titrate up and down for who

A

DOWN for non-malignant pts and elderly
UP for everyone else

187
Q

Side effects of opioids and how to treat

A

build up tolerance after 3-5 days
causes constipation
ambulate, drink water and fiber

188
Q

end product of muscle metabolism

A

creatinine

189
Q

how much to elevate legs in fluid overload

A

6 inches

190
Q

S&S of hyponatremia

A

lethargy
headache
confusion
apprehension
seizures
coma

191
Q

hypervolemic hypernatremia

A

sodium increases more while body water increases not as much

192
Q

hypovolemic hypernatremia and causes

A

body water decreases faster than sodium
adrenal insufficiency
V/D
suctioning

193
Q

pseudohyperkalemia

A

lab error from:

traumatic venipuncture
hemolysis, thrombocytosis, leukocytosis
clenching of fist during phlebotomy

194
Q

drugs that cause hyperkalemia

A

digoxin
K+ sparing diuretics
NSAIDS
ACE
BB
abx
heparins
penicillin G

195
Q

IC shift hyperkalemia

A

K+ release due to cell lysis
K+ release with intact cell membrane

196
Q

foods to avoid in chronic renal failure

A

dried fruits
seaweed
nuts, molasses
avocadoes
lima beans
spinach, potatoes, tomatoes, broccoli, carrots
kiwis, mangoes, oranges, bananas, cantalopue

197
Q

Ca treatment given with what

A

Mg

198
Q

2 electrolyte imbalances caused by low Mg

A

hypocalcemia bc mg needed for PTH
hypokalemia bc this induces K+ renal wasting

199
Q

resp alkalosis S&S

A

Seizures
Hyperventilation
Tachycardia
Tachypnea
Decreased or normal BP
Hypokalemia
Numbness or tingling in extremities
Lethargy and confusion
Lightheadedness
Nausea, vomiting
Hypocalcemia

200
Q

what to check in metabolic acidosis

A

potassium levels

201
Q

Normal blood counts

A

normal PLT count is 144k
WBC: 4,500-11,000

202
Q

resp alkalosis risk factors

A

Hyperventilation (most common cause)
Can cause hypocalcemia
anxiety
salicylates
disease states
mechanical over-ventilation
hypermetabolic states
acute hypoxia
pulmonary disease
severe anemia
pulmonary embolus
hypotension
syncope
hyperactive deep tendon reflexes

203
Q

metabolic acidosis S&S

A

hyporeflexia
disoriented, weak, coma
N/V/D
dehydration
facial flushing (seen w kidney failure)
peripheral edema
weak pulse
hypotension
hyperventilation

Med-Surg I (6 decks)

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